Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, People's Republic of China.
Eur Spine J. 2022 Oct;31(10):2536-2546. doi: 10.1007/s00586-022-07304-w. Epub 2022 Jul 19.
There are conflicting opinions regarding the efficacy of chewing gum for the recovery of gastrointestinal function in patients following spinal surgery. Thus, we aimed to conduct a systematic review and meta-analysis of existing articles to evaluate the effect of gum-chewing on patients following spinal surgery.
A computer search was used to identify randomised controlled trials (RCTs) involving gum-chewing from eight databases: Cochrane Library, PubMed, Embase, MEDLINE, Web of Science, China National Knowledge Infrastructure, China Science and Technology Journal Database, and WanFang Data. After evaluating the risk of bias for the included studies, we used the Revman 5.3 software to conduct a meta-analysis of the data.
The study included seven RCTs, with a total of 706 patients. The meta-analysis reported that gum-chewing could shorten the interval between surgery and first bowel movement (mean deviation [MD] = - 23.02; 95% confidence interval [CI]: - 24.67, - 21.38; P < 0.00001), first flatus (MD = - 1.54; 95% CI - 2.48, - 0.60; P = 0.001), and first bowel sounds (MD = - 5.08; 95% CI - 6.02, - 4.15; P < 0.00001). Moreover, there was a significant reduction in postoperative analgesic dosage within 12 h (standardised mean difference [SMD] = - 0.28; 95% CI - 0.52, - 0.05; P = 0.02). However, there were no significant differences between the chewing gum and control groups (P > 0.05) regarding the postoperative nausea score, abdominal pain score, 24- and 48-h analgesic drug dosage, and length of hospital stay.
To a certain extent, masticating gum can promote the recovery of gastrointestinal function and reduce the need for postoperative analgesics in patients following spinal surgery. However, this conclusion is affected by the quantity and quality of the included articles. Therefore, additional high-quality studies are needed to verify these results.
关于咀嚼口香糖对脊柱手术后患者胃肠功能恢复的疗效，目前存在不同意见。因此，我们旨在对现有的研究进行系统评价和荟萃分析，以评估咀嚼口香糖对脊柱手术后患者的影响。
计算机检索 Cochrane 图书馆、PubMed、Embase、MEDLINE、Web of Science、中国知网、中国科技期刊数据库和万方数据 8 个数据库中关于咀嚼口香糖的随机对照试验（RCT），评价纳入研究的偏倚风险后，采用 RevMan 5.3 软件进行荟萃分析。
共纳入 7 项 RCT，合计 706 例患者。荟萃分析结果显示，咀嚼口香糖可缩短手术至首次排便时间[均数差值（MD）=-23.02，95%置信区间（CI）：-24.67，-21.38；P<0.00001]、首次肛门排气时间（MD=-1.54，95%CI：-2.48，-0.60；P=0.001）和首次肠鸣音时间（MD=-5.08，95%CI：-6.02，-4.15；P<0.00001），术后 12 h 内的镇痛药物用量也显著减少[标准化均数差值（SMD）=-0.28，95%CI：-0.52，-0.05；P=0.02]。但咀嚼口香糖组与对照组的术后恶心评分、腹痛评分、24、48 h 镇痛药物用量和住院时间比较，差异均无统计学意义（P>0.05）。
咀嚼口香糖在一定程度上可促进脊柱手术后患者胃肠功能恢复，减少术后镇痛药物的使用，但该结论受纳入研究数量和质量的影响，需要更多高质量研究予以验证。
